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Migraine prophylaxis medication; is it all placebo effect?

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How many times have you prescribed migraine prophylaxis for a child with migraine? How good is the evidence that any of the drugs work? Anecdotally, Archivist has felt that there have been some useful medications out there. In a revealing systematic review, Locher C et al . [JAMA Pediatr. 2020;174(4):341–349. doi:10.1001/jamapediatrics.2019.5856] have analysed twenty-three randomised controlled studies examining prophylactic pharmacologic treatments in 2217 children and adolescents diagnosed as having episodic migraine. They used the data extraction methods according to preferred reporting items for systematic reviews and meta-analysis network guidelines. What are the most effective, safe, and accepted pharmacologic treatments for …

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